Selecting The First Biologic in IBD

Biologic therapy is becoming the standard of care for many patients with moderate to severe Inflammatory Bowel Disease (IBD). The decision of selecting the right agent for the right patient requires careful attention to several factors that are related to both; the drug and the patient. Efficacy, safety profile, need of combination with immunomodulators and cost of therapy are some of these aspects. From patient perspective, we have to take into account presence of comorbidities, the overall health condition and preference for mode of delivery of the drug.

The figure below illustrates the available classes of biologics that can be used for treatment of IBD. The scope of this lecture is to provide a guide for positioning the available biologics based on up to date guidelines recommendations and trials.